The diffuse large B-cell lymphoma category of the Revised European American Classification of Lymphoid Neoplasms (REAL) encompasses different morphologic lymphoma subtypes in a single entity, especially the diffuse large cell (DLC) and the immunoblastic (IBL) subtypes by Working Formulation (WF). The aim of this study is to determine the influence of the morphologic subdivision within this category with respect to clinical outcome and proliferative index using Ki-67 immunostainig combined with image analysis. We retrospectively reviewed 74 patients from 1990 to 1996, who were diagnosed with diffuse large B-cell lymphoma. All cases were reclassified according to REAL and Working Formulation (WF), and Ki-67 immunostaining was performed in all the cases. Fifty-eight cases (78.4%) were classified as DLC and 16 cases (21.6%) as IBL, according to WF. Twenty one cases (28.4%) showed nodal involvement and 53 cases (71.6%), extranodal involvement. All cases were found to display a variable degree of nuclear Ki-67 staining. A proliferative index of 50% or higher identified a group of patients (77%) who had poor clinical results. Overall survival was significantly reduced in these patients displaying high Ki-67 associated proliferative index compared to those with a low proliferative index (p=0.007). 5-year survival estimates were 93% in the low proliferative index group and 55% in the high proliferative index group. A multivariate regression analysis incorporating commonly used clinical prognostic factors confirmed the independent effect of proliferation index on survival. Moreover, all of the 16 IBL cases showed Ki-67 positivity of 50% or higher, which correlates with the poor clinical outcome compared to 70.7% of DLC (p=0.014). We conclude that subdivision of the diffuse large B-cell lymphoma category of the REAL classification is necessary in terms of prognostic significance in correlation with Ki-67 proliferative index.
B-Lymphocytes* ; Classification ; Humans ; Lymphoma ; Lymphoma, B-Cell* ; Lymphoma, Large B-Cell, Diffuse ; Retrospective Studies

Of all the aeromedical treats to flying safety, G-induced loss of consciousness (G-LOC) must be one of the most important. The present study is undertaken to acquire the physiological normative data (including lifestyle and physical fitness) of KAF pilots and to investigate the factors that will be related with G-LOC. From 15 May through 27 Nov 2000, 464 KAF pilots underwent high G training and flight performance tests at the Aeromedical Research and Training Center are checked CBC, total cholesterol, PFT, physical fitness battery tests-muscular strength, muscular endurance, power, and flexibility. High G training and 2 kinds (before and after the G-training) of questionnaire were tried. Pilot's attitude for health promotion was relatively passive and the proportions as of high and borderline risk for atherosclerosis in total cholesterol level were 4.98% and 22.1%, respectively. 17.6% of the pilots had G-LOC and three quarters of them fell into G-LOC within the first 5 seconds. Variables showing significant correlation (p<0.05) with G-LOC were as follows; height, age, total flying time, and high G-training times. Trunk extension had positive correlation and curls ups had negative correlation, but the reasons are needed more following study. Also, the judgments of pilots and a supervisor in skillfulness of L1 maneuver were significant with G-LOC.
Atherosclerosis ; Cholesterol ; Diptera ; Health Promotion ; Judgment ; Life Style ; Physical Fitness ; Pliability ; Risk Factors* ; Unconsciousness ; Surveys and Questionnaires

PURPOSE: To investigate the phosphorus metabolic abnormalities in skeletal muscle of patients with mitochondrial myopathy using in vivo 31P magnetic resonance spectroscopy(MRS). MATERIAL AND METHODS: Patients with mitochondrial myopathy(N=10) and normal control subjects (N=10) participated. All in vivo 31P MRS examinations were performed on 1.5T whole-body MRI/MRS system by using an image selected in vivo spectroscopy (ISIS) pulse sequence that provided a 4 X 4 X 4 cm3 volume of interest (VOI) in the right thigh muscle tissue. Peak areas for each phophorus methabolite were measured using a Marquart algorithm. RESULTS: The specific features in patients with mitochondrial myopathy were a significant increase of Pi/PCr ratio (p=0.003) and a significant decrease of ATP/PCr ratio (p=0.004) as compared with normal controls. In particular, the beta-ATP/PCr ratio between controls and patients with mitochondrial myopathy was predominantly altered. CONCLUSIONS: In vivo 31P MRS may be a useful modality in the clinical evaluation of patients with mitochondrial myopathy based on ATP/PCr and Pi/PCr ratios in skeletal muscle tissue and provides a valuable information in further understanding disorders of muscle metabolism.
Humans ; Magnetic Resonance Spectroscopy* ; Metabolism ; Mitochondrial Myopathies* ; Muscle, Skeletal ; Phosphorus ; Spectrum Analysis ; Thigh